Muscles of the Soft Palate

The Levator Veli Palatini (Levator Palati)

• Superior attachment: cartilage of the auditory tube and petrous part of temporal bone.
• Inferior attachment: palatine aponeurosis.
• Innervation: pharyngeal branch of vagus via pharyngeal plexus.
• This cylindrical muscle runs inferoanteriorly, spreading out in the soft palate, where it attaches to the superior surface of the palatine aponeurosis.
• It elevates the soft palate, drawing it superiorly and posteriorly.
• It also opens the auditory tube to equalise air pressure in the middle ear and pharynx.

The Tensor Veli Palatini (Tensor Palati)

• Superior attachment: scaphoid fossa of medial pterygoid plate, spine of sphenoid bone, and cartilage of auditory tube.
• Inferior attachment: palatine aponeurosis.
• Innervation: medial pterygoid nerve (a branch of the mandibular nerve).
• This thin, triangular muscle passes inferiorly, and hooks around the hamulus of the medial pterygoid plate.
• It then inserts into the palatine aponeurosis.
• This muscle tenses the soft palate by using the hamulus as a pulley.
• It also pulls the membranous portion of the auditory tube open to equalise air pressure of the middle ear and pharynx.

The Palatoglossus Muscle

• Superior attachment: palatine aponeurosis.
• Inferior attachment: side of tongue.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
• This muscle, covered by mucous membrane, forms the palatoglossal arch.
• The palatoglossus elevates the posterior part of the tongue and draws the soft palate inferiorly onto the tongue.

The Palatopharyngeus Muscle

• Superior attachment: hard palate and palatine aponeurosis.
• Inferior attachment: lateral wall of pharynx.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
• This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
• It passes posteroinferiorly in this arch.
• This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.

The Musculus Uvulae

• Superior attachment: posterior nasal spine and palatine aponeurosis.
• Inferior attachment: mucosa of uvula.
• Innervation: cranial part of accessory through the pharyngeal branch of vagus, via the pharyngeal plexus.
• It passes posteriorly on each side of the median plane and inserts into the mucosa of the uvula.
• When the muscle contracts, it shortens the uvula and pulls it superiorly.

The Salivary Glands

• There are three large, paired salivary glands: the parotid, submandibular, and sublingual glands.
• In addition to the main salivary glands, there are numerous small accessory salivary glands scattered over the palate, lips, cheeks, tonsils, and tongue.

Structure of the Nasal Septum

• This part bony, part cartilaginous septum divides the chamber of the nose into two narrow nasal cavities.
• The bony part of the septum is usually located in the median plane until age 7; thereafter, it often deviates to one side, usually the right.

• The nasal septum has three main components: (1) the perpendicular plate of the ethmoid bone; (2) the vomer, and (3) the septal cartilage.

• The perpendicular plate, which forms the superior part of the septum, is very thin and descends from the cribiform plate of the ethmoid bone.
• The vomer, which forms the posteroinferior part of the septum, is a thin, flat bone. It articulates with the sphenoid, maxilla and palatine bones.

The Temporalis Muscle

• This is an extensive fan-shaped muscle that covers the temporal region.
• It is a powerful masticatory muscle that can easily be seen and felt during closure of the mandible.

• Origin: floor of temporal fossa and deep surface of temporal fascia.
• Insertion: tip and medial surface of coronoid process and anterior border of ramus of mandible.
• Innervation: deep temporal branches of mandibular nerve (CN V³).

• The temporalis elevates the mandible, closing the jaws; and its posterior fibres retrude the mandible after protrusion.

Nerve Supply of the Muscles of the Orbit (pp. 715-6)

• Three cranial nerves supply the muscles of the eyeball; the oculomotor (CN III), trochlear (CN IV) and abducent (CN IV) nerves.
• All three enter the orbit via the superior orbital fissure.

• The trochlear nerve supplies the superior oblique muscle.
• The abducent nerve supplies the lateral rectus muscle.
• The oculomotor nerve supplies everything else.

• A mnemonic that is used is this formula for this strange sulfate: SO₄(LR₆)₃

The Medial Wall of the Orbit 

• This wall is paper-thin and is formed by the orbital lamina or lamina papyracea of the ethmoid bone, along with contributions from the frontal, lacrimal, and sphenoid bones (L. papyraceus, "made of papyrus" or parchment paper).

• There is a vertical lacrimal groove in the medial wall, which is formed anteriorly by the maxilla and posteriorly by the lacrimal bone.
• It forms a fossa for the lacrimal sac and the adjacent part of the nasolacrimal duct.

• Along the suture between the ethmoid and frontal bones are two small foramina; the anterior and posterior ethmoidal foramina.
• These transmit nerves and vessels of the same name.